Provider Demographics
NPI:1053304337
Name:SUNSET MANOR, INC
Entity Type:Organization
Organization Name:SUNSET MANOR, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KNAUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-231-7340
Mailing Address - Street 1:206 S DITTMAN ST
Mailing Address - Street 2:
Mailing Address - City:FRONTENAC
Mailing Address - State:KS
Mailing Address - Zip Code:66763-2253
Mailing Address - Country:US
Mailing Address - Phone:620-231-7340
Mailing Address - Fax:620-231-3955
Practice Address - Street 1:206 S DITTMAN ST
Practice Address - Street 2:
Practice Address - City:FRONTENAC
Practice Address - State:KS
Practice Address - Zip Code:66763-2253
Practice Address - Country:US
Practice Address - Phone:620-231-7340
Practice Address - Fax:620-231-3955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS175363Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER